#67 - Hot Flashes 101: Can you eat to beat the heat?

If you’ve begun your menopause journey, you’ve probably had to deal with hot flashes by now. When they first start, they can certainly take you by surprise, especially since the experience of them can vary a lot from person to person. But however they show up, they are always uncomfortable and disruptive. 

In this episode, I’m going to break down what is happening in your body (more specifically in your brain) when hot flashes strike. I’ll also share what foods you might be eating or drinking that can impact how often you have them, as well as simple (and tasty) foods you can eat to support the rollercoaster of hormone changes in this age and stage of life

📚 I wrote a book! Eat To Thrive During Menopause is out now!  Order your copy today and start thriving in midlife.

Transcript

Copy Transcript Copied

Jenn Huber  0:02  
Hi and welcome to the midlife feast the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Selena Huber. Come to my table. Listen and learn from me. Trusted guests, experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. Hey, everyone, welcome to this week's episode of the midlife feast, we are taking on hot flashes. So hot flashes, unsurprisingly, are the most common symptom experienced by people going through the menopause transition. And so this, you know, this group of symptoms that we call vasomotor symptoms are by far the most common. This includes hot flashes, night sweats, heart palpitations, and even blood pressure changes. But today specifically, we're going to be talking about hot flashes, and night sweats, what they are, what you can do about them. And I'm going to talk about my favorite thing, which is, of course, the relationship between food and hot flashes and what you might be able to eat more often to help stay calm, cool and collected. Okay, so what exactly is a hot flash and I remember being so taken aback, the first time I had an honest to goodness hot flash, because I had this wave of almost nausea and panic come over me. And then just felt like I had this burning that was starting in my chest, or on my breastbone and moving up. And I really thought that I was going to be sick, like I thought I was going to throw up and then felt very warm, very hot, very distracted by it, because you can't not notice a hot flash. And you know, I have quite pale skin all that Scottish heritage. And as a result, I get blotchy and red. I didn't. I don't usually sweat when I have a hot flash, but I would always get blotchy and red. And people would say, are you okay, and then a couple of minutes later, it was gone. And so I finally realized that this was a pattern and that what was happening was these hot flashes. So I always like to describe to people that hot flashes can be experienced differently. Some people do get red and hot and sweaty, some people don't. Most people feel that they start in their chest, shoulders, neck and move up. For most people, it lasts a couple of minutes. And there are definitely circumstances that we'll talk about, that may bring them on more often. And of course, things that you can do that might make you less susceptible to them. But what is actually happening is that your brain and the part of your brain that regulates temperature, short circuits. And so contrary to popular belief, a hot flash isn't actually a change in your body temperature, so much as it is a change in your skin temperature because of this short circuit in your brain. So because we have receptors for estrogen and progesterone in our brain, and as we go through these fluctuations have periods of you know, high and low, but with hot flashes, we're mainly talking about estrogen, it does also happened with progesterone. But when we have these big drops in estrogen, the thermostat short circuits and thinks that we're overheating. So as a result, it sends blood to our skin to release the heat, because that's what our brain does is it tries to maintain this particular body temperature. But because it's not actually too hot, it just thinks it's too hot. We also then get cold really quickly. And so one of the more common experiences that people have is getting really hot and then getting really cold and sometimes even shivering. So it's so much fun to be hot and cold, freezing and overheating in the span of two or three minutes all at once. Of course I'm being sarcastic, but that's essentially what a hot flashes and hot flashes that happen at night are called Night sweats. And not again, not everyone's sweats, I would say it's even more common or certainly just as common for people to wake up in the middle of the night and just feel warm, have to throw the covers off. Many of us even in post menopause as I raise my hand still sleep with a fan. And you know, we just like cooler temperatures and we like a little bit more control over not getting too warm. So all of these things are fall under that umbrella of vasomotor symptoms especially hot flashes and night sweats. So, again, most common 75 plus percent of people going through this transition will experience them the experience of them is very, very wide. So you know you'll talk to some people who barely have any but have had some and then you talk to some people who are having 20 or 30 a day you know I'm not even joking. For some people, they're minimally disruptive for some people, they're very disruptive, there is likely like most things, a genetic component. And there is some early research emerging that maybe the severity of your hot flashes may also be tied to other risk factors around heart disease, which kind of makes sense. Again, if we think about the link to you know, blood pressure changes are also a vasomotor symptoms. So I think let's just, let's just say that not everyone experiences hot flashes, but most experienced some in some way. So what can we do about it? So the most obvious thing is controlling external environmental temperature. So, you know, there's this thing called this thermo regulatory zone, which is the thermostat. So let's call that the thermostat. When you're in Perry, or pre menopause, I should say so before perimenopause, your thermostats ceiling and floor is quite generous. Think of it as like, you know, a 16 foot ceiling. So it takes a lot for you to feel hot, and it takes a lot for you to feel cold. But then as you get into perimenopause, and menopause, you're thermo regulatory zone, the ceiling and the floor of that become more like a basement and an old house. So the ceiling of when you feel warm, happy, you reach it much more quickly. And the floor of when you feel cold is also something that you might feel surprised at how quickly that happens. So being able to regulate your environment, your environmental temperature, with clothing, or thermostats, or fans, or whatever that is, will absolutely be helpful. So we're essentially trying to prevent your, you know, trying to control the temperature of your skin so that if your thermostat does have a short circuit that you can work together with it to try and get back to some kind of homeostasis. So the other thing is with the temperature of your foods, so hot beverages of any kind, not just coffee and tea, which we'll talk about in a second, but hot beverages of any kind, spicy foods, hot soups, any of these can contribute to that short circuiting. So, you know, letting your your coffee in the morning cool a little bit, maybe not having piping, hot soup, may be easing back on spicy foods. But again, this isn't true for everyone. These are just the most common associations that we have noticed, that seem to be true for many, but not all people. So let's talk about caffeine. So anything that increases your heart rate, which is why there's also a connection to stress, but anything that increases your heart rate, which includes caffeine, unfortunately, can trigger a hot flash for some people. And as I always say, though, you will have to pry my morning coffee out of my cold dead hands hot flashes are not. You know, it doesn't mean that you have to get rid of your morning coffee. But if you notice that, oh, you know, two sips or half a cup into my morning coffee, I'm getting a hot flash and that hot flashes enough to bother you and affect you, then maybe you're going to switch to try switching to like iced coffee, or having you know waiting for it to cool or maybe having half decaf, but most people don't have to give up entirely. But many people to notice that having less or having it less often or having less hot coffee can make a big difference in how many hot flashes and how severe or how impactful those hot flashes are. So the next association is with alcohol. And one of the first things that I noticed in my early Peri menopausal days was that red wine in particular, had to go I think I had my last glass of red wine on my 40th birthday because even just half a glass was you know, really contributing to my hot flashes and especially night sweats at night. That seems to be true.

Jenn Huber  8:54  
I've spoken to 1000s of women at this point who have told me the same thing. I think there's something to that red wine is higher and tannins I have some theories. So red wine is higher in tannins, which you know, are astringent, and that may contribute to it. It's also higher in histamine so there may be that component to it. But alcohol also dehydrates us, which is why all alcohol not just red wine may contribute to hot flashes because it will increase our heart rate through dehydration and also disrupt sleep so we don't get into as deep of asleep when we have consumed alcohol, which may also be related to hot flash frequency and severity. So all that to say, you know, I joke that you know I haven't I don't avoid alcohol entirely, but I certainly have much less of it because it is largely self selected its way out of my life. And I enjoy a good mocktail more often than cocktails these days, so just something to think about. But the thing that saved me when hormone therapy proved not to be for Mi was including foods that are high in phyto estrogens. And so that's what I really want to focus on with this week's podcast episode, which is what can I try on? What can I add in that may really help to reduce the frequency and severity of of my hot flashes? So first let's talk about what are phyto estrogens? Where do I find them? How much do I need, but starting with what are phyto estrogen so phyto estrogens are a group of plant compounds are founded all plants but they are higher in some than others that have the ability to bind to some of our estrogen receptors, there are a couple of different types of estrogen receptors that we have. And phyto estrogens tend to bind to the beta receptor, which is not the dominant estrogen receptor that we're usually talking about when we talk about estrogen. And that's a good thing. Because this is also why it is considered to be safe and unlikely at this point based on current evidence to increase the risk of things like breast cancer and may in fact reduce the risk of many of those types of cancers. But from a hotflush perspective, what's happening is that because our estrogen receptors are used to having lots of estrogen, and then all of a sudden don't have a lot of estrogen. Anything that can help to plug the holes can bind to those receptors may reduce the frequency and intensity. And that seems to be how they work. Now, they don't work for everyone. And this is often the big point of confusion with, you know, women and health practitioners is well, why don't we have stronger evidence for this? Why can't we definitively find? You know, why can't we prove this once and for all? Anything related to proving nutrition with a study is difficult. So here's what we do know about them. We know that certain cultures, especially, you know, Japan, and China and other Asian cultures, who tend to consume more foods that are high in phyto estrogens including soy, particularly soy report, fewer hot flashes. Now, that doesn't prove anything. But it's an association that has long been established. Now there could be other reasons why they don't experience the same types of symptoms, especially hot flashes that we do. But there is also quite a bit of research that tells us that yes, we do know that these phyto estrogens, especially the isoflavones from soy and the lignans, which are a different type of phyto. Estrogen from flax can bind to these receptors. And there have been a number of studies which have certainly pointed strongly and statistically significantly in the right direction to say that, it seems likely that hot that hot flashes frequency can be reduced for many women, not all by including soy. But it is difficult to prove. And I'm the first to acknowledge that. But the other reason why I say it's worth a try is that there's no harm, there is no risk. The foods that are that are high in phyto estrogens are foods that I often suggest adding in because they're also high in protein. They are also high in fiber, they're nutrient dense, they're delicious. And you know, lots of people find that even if they don't help with their hot flashes, which, you know, I don't actually find to be the case most of the time. But even if they don't, they're like, Yeah, I think I'm gonna gonna still keep eating them. So, to me, it's a win win. And I really do believe that, that for most people, it is beneficial if they're able to include them often enough, and the right types. And so this is where dose and frequency matter the most. So the next question is always okay, I'm willing to give these, you know, foods a try, how much do I need to have and how often, again, this is difficult because when they've looked at this in the research, some of the studies are looking at food. Some of the studies are looking at supplements. And it's very difficult to compare them both because we're not comparing apples to apples. And then it's also very difficult to compare it to some of the observational studies from countries like Japan, because we're relying primarily on people telling us what they're eating, we're not controlling what they're eating so that we can really say beyond a shadow of a doubt that it's this food that is causing this effect. So how much you need to eat will be individual and I will usually recommend that people start with several servings a week and taking it from there and this could be soy milk, this could be tofu, this could be at a mommy this could be soy nuts, this could be flax, and also should include other beans and lentils because you know including these other Types of high fiber plant based foods do contain some phytoestrogens, but probably more importantly, they also contribute to building and growing and maintaining the types of bacteria in our gut that may also be involved in how well we respond to soy foods. But the most important thing is that you're including them regularly and that you're having enough of them. And so, you know, in terms of dose, this is probably like a cup of soy milk a day, or, you know, three quarters of a cup of edamame a or three ounces of tofu. And for most people, this this is fairly doable. And so one of the things that I love doing in my work and including in the midlife feast membership is giving people lots of easy recipes and suggestions for ways to just try these foods on because it doesn't have to be complicated. If you're using regular milk, we switch to soy milk, you know, and tofu is not as intimidating as it sounds, I promise I have lots of recipes that most people find everyone in their family likes, or at least they like enough to want to make for themselves. But it doesn't have to be tofu. So if you hate soy, that's okay, we can, I'm never going to tell you that you have to eat something you hate. That is definitely not part of my philosophy. But I do love trying to support people trying these foods on because I do think that it can make a big difference. Flax is also involved. So flax is interesting, because it's the type of phyto estrogen that's in flax is slightly different than the one that's in soy. So it's very challenging to kind of say exactly how much people need. But I usually suggest including a tablespoon or so a day. And again, you can do this by adding it to foods you can also bake with with ground flax. So one of my favorite tips is that you can substitute a quarter cup of any flour for ground flax, which is a really easy way to not just get those lignans and phyto estrogens, but also some of the fiber that we can enjoy the soluble fiber that we can enjoy from flax. But the most important thing is that you have in your mind a period of time, and a plan for you to try this on consistently so that you can know for sure, yes, this helped. No, it didn't. And I'm going to move on. And so that's what I love to help people with. And if you're looking for help with that, you can click the link in the show notes and learn about the midlife peace membership or how to work with me, because I love helping people to sort this out and really make it kind of part of their just everyday relationship with food. But if it doesn't work for you, and if or you know, if for whatever reason, it's not the way that you want to treat your hot flashes, I do think it's important not just to ignore them, because yeah, they are normal, quote unquote. And yes, they will probably go away at some point on their own. But man Do they ever get in the way of life, they are not fun, and I just don't think we should have to wing it. And you know, it's another one of the things I say all the time is just because it's normal doesn't mean that we have to wing it. So, other options to explore obviously, hormone therapy is very, very effective and probably probably hot flashes are the symptom that improves most consistently, most quickly. And the reason why people love hormone replacement therapy or menopause hormone therapy is

Jenn Huber  18:15  
that it will, you know, take care of those hot flashes for most people. There are also a number of non hormonal medications, prescription medications that your that your doctor or prescriber can talk to you about because you know for some people who can't or don't want to take hormones, those are some options. And if you're working with a naturopathic doctor, there are also you know, definitely some options to look at on the herbal medicine, the botanical side. And those are things that you know, I think people can can know and explore safely with the help of a registered or licensed naturopathic doctor. And then there's the lifestyle stuff. So yes, movement does seem to help so some of the research on exercise is funny because anything that increases your heart rate increases the likelihood that you might experience a hot flash, but on the whole people who have a regular movement routine or exercise more regularly report fewer hot flashes and or are less bothered by them. So yeah, I might be more likely to have a hot flash if I get my sweat on but at the same time, I do know that it helps me to cope with them as a long term strategy, meditation, relaxation, yoga, all of these can also contribute so on that, you know, managing your stress, supporting your sleep and just doing the things that help you to feel more calm and relaxed. These are also likely to help so I hope that this quick little episode which I guess is almost 20 minutes so not quite as quick as I thought it was going to be has given you a bit of insight and clarity into what is a hot flash. What is happening, what can I do about it and specifically, what might you be able to try on with food that will help you to feel more calm, cool and collected Thanks for tuning in to this week's episode of the midlife deal. For more non diet health hormone and general midlife support. Click the link in the show notes to learn how you can work and learn from me. And if you enjoyed this episode and found it helpful, please consider leaving a review or subscribing because it helps other women just like you find us and feel supported in midlife.